MEDICARE: DR. SAMIRAH KWAJALEIN FURMAN PHARM.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	20169	NV

General Provider Information

NPI Number	:	1396356184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAMIRAH KWAJALEIN FURMAN PHARM.D

Provider Business Mailing Address
First Line	:	3030 LAS VEGAS BLVD N
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89030-5756
Country	:	US
Telephone Number	:	702-642-5318
Fax Number	:	702-657-6985

Provider Business Practice Location Address
First Line	:	3030 LAS VEGAS BLVD N
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89030-5756
Country	:	US
Telephone Number	:	702-642-5318
Fax Number	:	702-657-6985

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/14/2020
Last Update Date	:	08/14/2020

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